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The journal Pelvic Health

What to Expect at Your First Pelvic Floor Physical Therapy Session

By Dr. Allison Feldt, PT, DPT 4 min read

At Body Motion Physical Therapy, our goal is to help you feel strong, confident, and fully supported in your body. As a pelvic health specialty clinic, we work with individuals through every stage of life, including pregnancy, postpartum recovery, fertility, and midlife transitions such as perimenopause and menopause.

If you have ever wondered what pelvic floor physical therapy actually looks like, you are not alone. It is completely normal to feel curious or even a little unsure about what to expect. Understanding the process ahead of time can help you feel more comfortable and confident walking into your first session.

Pelvic floor physical therapy is about much more than just the pelvic floor. At Body Motion, we take a whole-body approach because your symptoms are rarely isolated to one area. Everything in your body is connected, and your care should reflect that.

Your first session begins with a comprehensive review of your history. This includes past injuries, even those from childhood, your activity background, any surgeries or scar tissue, pregnancy and birth history, and your current symptoms and goals. Your body holds onto past patterns, and understanding your history helps us identify the root cause of what you are experiencing.

From there, we assess how your body moves as a whole. You will remain fully clothed during this portion while we evaluate your feet, knees, hips, spine, posture, and upper body. This allows us to see how your system is functioning together and where imbalances or compensations may be contributing to your symptoms.

Next, we move into hands-on assessment. We evaluate muscle tension, mobility, and coordination throughout your abdomen, hips, and glutes, along with how your joints are moving. This portion may feel similar to massage, but it is highly specific and designed to identify areas of restriction, weakness, and dysfunction.

We also assess the abdominal wall and internal organ mobility. This includes checking for abdominal separation and evaluating any scar tissue from surgeries such as C-sections, laparoscopic procedures, or other abdominal operations. Scar tissue can limit movement and affect how your core functions, so restoring mobility in these areas is an important part of the process.

If appropriate and with your full consent, we may include an internal pelvic floor assessment. You will be comfortably draped, and the exam is performed with gloved hands using a single finger. Every step is explained clearly so you feel informed and in control throughout the process.

During this assessment, we evaluate muscle tone, tissue quality, strength, coordination, and the ability of the pelvic floor to both contract and relax. We also identify areas of tension, restriction, or scar tissue that may be contributing to your symptoms. The pelvic floor consists of multiple layers, and each layer plays a role in how your body functions.

This is often the moment where everything starts to make sense. Many patients recognize their symptoms immediately during the assessment, whether it is pain they have felt in their abdomen, discomfort during intimacy, or tension that connects to their back or hips. The pelvic floor is deeply integrated with the rest of the body, and it can be a key driver of symptoms that seem unrelated at first.

Treatment begins during your first session. This may include releasing tight muscles, addressing scar tissue, and introducing breathing strategies that help your pelvic floor function more effectively. Many patients notice a difference right away, including improved mobility, decreased tension, and a greater sense of ease in their body.

After your session, we develop a personalized plan of care based on your specific needs, goals, and findings from the evaluation. This plan takes into account your stage of life, the duration and severity of your symptoms, and what will best support your progress.

Whether your goal is to return to exercise, improve intimacy, prepare for birth, or simply move through daily life without discomfort, your care is designed to support you in getting there.

It is completely normal to feel some hesitation about starting pelvic floor therapy. This type of care is not widely talked about, and it can feel vulnerable. At Body Motion Physical Therapy, we prioritize clear communication, consent, and creating a supportive environment where you feel comfortable every step of the way.

Most patients find that once they begin, the initial uncertainty fades quickly. As your body starts to feel better, your confidence grows, and the experience becomes something you look forward to.

Pelvic floor physical therapy can be a powerful step toward feeling better in your body. If you are experiencing symptoms or simply want to be proactive about your health, this is a meaningful place to start.

If you have questions before your first visit, we are here to support you and help you feel prepared.

Dr. Allison Feldt, PT, DPT, founder of Body Motion Physical Therapy

About the author

Dr. Allison Feldt, PT, DPT

Allison is a pelvic floor physical therapist and the founder of Body Motion PT in Edmonds. A mom who knows the aftermath of pregnancy and birth firsthand, she's on a mission to help women restore their core and pelvic floor at every stage of life.

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